Claims of Health Insurance Plans should be real and not for earning profits by having multiple health insurance policies as it will lead into problem while the claim is needed.
Health Insurance Plans are essential for every person as it gives security and safety to the insured person with various benefits. There are various kinds of health insurance policies such as Individual Health Insurance Plans, Family Floater Plan, Children Insurance Plan, Car Insurance Plan, Mediclaim etc.
These plans are different from each other in which suppliers can be seen and the amount to pay can be guessed, so it is much more important to know about the costs and essential health insurance terms. This knowledge will help the insured to know about the services which has to be paid according to plan and the amount to pay on each visit to the doctor. Now-a-days medical costs are growing up at a gallop it is important to take a health insurance plan for meeting those costs here are some information about choosing Multiple Health Insurance Plans.
Reasons to buy Multiple Health Plans
Seniors are the most important part of every family and in everyone’s life as they spend their whole life for their children, sacrifice their dreams and work hard to raise them as respectable persons in the society. Their age is the proof of their important roles in the family, is the proof that they now need some extra care and protection from the other young members of the family.
It gives deficient existing health insurance coverage
Insured has to pay higher premiums for the existing health insurance plan
Sometime people face poor claim experience with the insurance company
Multiple Health Plans are need to make a strong financial back up to decrease pocket charges
Risk or fear of claim rejection by the insurer
Types of Health Insurance Plans
Health Plans are divided as two types of plans such as ‘Based on indemnity’ and ‘Based on fixed benefits’.
Under Indemnity based health plans, the claim is fixed as per the real charges received and the actual cost of treatment where one can’t claim more than the claim amount. Whether the critical plans and personal accident plans are like fixed benefit plans those will give fixed amount or benefits regardless of the actual cost of the treatment. Insurance Plans work on some principles and one such is known as ‘Principle of Contribution’ or ‘Contribution Clause’ saying that when the policyholder buys insurance plans from different health insurance providers to mask a specified health event and after that the insurer funds the right to get the right amount of claim from the other insurers as per principle.
Here are some scenarios on which the claims are demanded by the policyholder, such as-
A person has two Critical Illness plans of Sum Assured 2 lakh and 1 lakh each and the insurer may not get the ‘Contribution Clause’ as the benefits are fixed under the health plan. So to get the claim the policyholder should have a critical illness which is fallen under his fixed benefit health insurance plan where he can claim for both treatment cost and the policy terminates after that.
A person has compensation based health plan covering 4 lakh and a Personal accident plan of 3Lakh; he has an accident and hospitalized where he needs to pay 2 lakh as the final amount of expenses. In case of this, the person can claim his total 3 lakh from his fixed benefit personal accident plan and can also claim up to 2 lakh from his compensation plan.
When there are two compensation based health plans from different health insurance plans of two different amounts from two different insurers, the insured person can claim his money a unique way. He has to decide at first from which insurance company he should claim who will pay him his benefits fast.
For Reimbursement Plan
The insured has to collect all the important documents from the hospitals and need to submit to the insure, the documents are like: completely and correctly filled Claim Form, Medical Certificate that confirms the diagnosis of the disease, Discharge Summary, Medical investigation reports and other supporting documents related to illness.
For Cashless Treatment
The chosen health insurance company for claim settlement will settle the claim directly with the help of hospital as per the rules and after the examination of contribution clause, policyholder will also follow the claims procedure.
Things to know while filling multiple claims at a time
Capability of claims of the insurers
Twisting around time of the insurer to set the claim
List of the network hospitals for cashless treatment
Method of claim settlement of the insurer
Need of the partnered TPA of the insurer
Existing claim insurance with the insurance companies
Check no claim bonus status, read the copayment clause, sub limits and other related clauses.